Virginia’s suicide rate is the highest it’s been in 13 years, according to the state’s chief medical examiner. Experts say the causes may include the poor economy and lack of mental health services.

In 2011, the most recent year for which data are available, there were 1,067 suicides in the state– 12.6 suicides per 100,000 residents. The numbers have risen steadily since 2003, when there were 804 suicides, a rate of 10.9 suicides per 100,000 population.

While suicides have increased, homicides– which draw far more media attention– have plunged from as many as 498 in 2005 to 345 in 2011. The result: Suicides are now three times more common than homicides in Virginia.

The suicide rates in 2011 were highest in the southwestern and western parts of Virginia. The rate per 100,000 people was 71.6 in the city of Galax, 49.3 in the city of Norton and more than 40 in Grayson, Highland, Bath and Page counties. Pockets of Central Virginia also had high suicide rates, such as Charles City County (55.2) and the city of Williamsburg (41.5).

Marc Leslie, coordinator of the Virginia Violent Death Reporting System, said many factors are involved in the increase in the suicide rate. “It’s a very complex, big problem so it’s hard to pin down” exact reasons, he said.

Leslie’s program, part of the medical examiner’s office, documented the trend in a study last year. “From 2003 to 2010 the number of suicides, and the resulting suicide rate, has increased. With the exception of 2007, the number and rate of suicides increased every year, reflecting a clear upward trend,” it noted.

“The overarching trend is that suicide appears to be increasing. The statewide rate for 2010 is well above the rate for 2003.”

Since then, the number of suicides jumped 7 percent from 996 in 2010 to 1,067 the following year, according to the latest annual report that the medical examiner’s office issued in December and updated in March.

It said suicides were most prevalent among Caucasians: “Whites committed suicide 5.2 times that of Hispanics, 4 times that of Asians, and 3.3 times that of blacks.”

The report also said males were 3.4 times more likely than females to commit suicide.

Suicides in Virginia: the numbers

There were 1,067 suicides in Virginia in 2011. They occurred most frequently with males (78 percent), whites (87 percent) and people age 45-54 years old (23 percent).

Alcohol was present in 29 percent of all suicides.

Handguns were used in 45 percent of suicides, followed by hanging (18 percent) and drugs (13 percent).

The most common months for suicides were April (101) and October (100). The least common were September (72) and February (76).

The most common day for suicides was Monday (196). The least common day was Saturday (132).

Virginia’s suicide rate was slightly above the national average.

Sources: The Virginia Office of the Chief Medical Examiner and the U.S. Centers for Disease Control and Prevention

“It’s not that more males develop a mental illness or make an attempt to take their life,” Harkey said. “It’s just as many females as males make an attempt on their life or develop a mental illness. More males complete suicide. They use lethal means such as guns, where a female tends to lean more towards a means like sleeping pills.”

Firearms, in fact, represented the most common method individuals used in committing suicide. More than half of the suicides in Virginia in 2011 involved self-inflicted gunshots.

People aged 45-64 accounted for about 40 percent of all suicides in the state. Harkey said that age group is a turning point in many peoples’ lives. “They’re thinking more about retirement,” she said. “They are maybe having health problems. Children have grown and gone. This is the age a lot of times, too, where spouses split up. There are a number of reasons why that could be at an increased suicide risk.”

Dr. Julie Linker, an associate professor of psychiatry at Virginia Commonwealth University, said mental health problems, combined with stressful circumstances, may incite some people to take their own lives.

“A combination of mental health and other factors are often at play. A person who is living with depression and then has an extra stressor come into their life, such as losing a job or an important relationship, failing at school, fight with a spouse, or a medical diagnosis, is at a higher risk for suicide,” Linker said.

“In areas where there is more economic hardship and joblessness, you see rates of suicides go up, and that is a reasonable hypothesis of what is happening here in Virginia.”

The unemployment rate in Virginia climbed from 3 percent or less in 2006-07 to as high as 7.4 percent in 2010. Since then, it’s dropped steadily, to 5.3 percent.

Localities with high suicide rates also tend to have high unemployment rates. For instance, the current unemployment rate is 7.7 percent in Galax, 7 percent in Norton, 10 percent in Grayson County, 9.2 percent in Page County and 11.7 percent in Williamsburg.

According to Linker, another factor may be the lack of access to mental health services.

“There is likely less access to mental health [treatment] and other support services in the areas where the suicide rates are the highest,” she said. “Depression is treatable, but difficulty accessing services and stigmas sometimes keeps people from getting the help that they need.”

Harkey said this number is a call for greater funding and more services for mental health treatment.

“Mental health is lacking in both [funding and services], and I think that is one of the biggest reasons we are steadily seeing an increase in suicide,” Harkey said. “We’re talking about spending billions on [gun control], and I’m thinking, ‘Wow, that needs to be put into mental health treatment, and then the problem will take care of itself.’”

Even so, help is available for people with suicidal thoughts or other mental health issues.

“There are suicide hotlines throughout the state that help people find resources in their communities. Family physicians or mental health treatment facilities are good places to start,” Linker said.

The National Suicide Prevention Lifeline is 800-273-TALK. The Virginia Department of Health has an entire website devoted to suicide prevention. The site includes the Virginia Suicide Prevention Resource Directory, which lists local hotlines, crisis centers, mental health centers and other services.